The role of educational theory in continuing medical education: has it helped us?

Despite the existence of many approaches to understanding learning and change and attempts to incorporate these into continuing education research and practice, the search continues for a comprehensive understanding of how learning is engendered in professional practice and the processes by which learning and change occur. This article considers four broad questions in relation to the practice of continuing education: (1) What can be expected of theory? (2) How does theory relate to the educational practice of those in continuing education and the goals of continuing medical education ? (3) How have practice and theory mutually informed our current understandings? (4) How can theory serve the field more effectively in the future? Broad orientations to understanding learning provide a framework for examining the contributions of theory and practice. The orientations include behaviorist, cognitivist, social learning, humanist, and constructivist; for each, an example is presented. Newer understandings also are introduced. The article concludes by considering reasons as to why theory appears not to have served us better and by offering ways in which those in continuing education can ensure greater usefulness of theory while contributing to its continued development.